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Shared preventive factors associated with relapse after a response to electroconvulsive therapy in four major psychiatric disorders

AIM: The efficacy of electroconvulsive therapy (ECT) has been established in psychiatric disorders but the high rate of relapse is a critical problem. The current study sought preventative factors associated with relapse after a response to ECT in a continuum of four major psychiatric disorders. MET...

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Autores principales: Omori, Wataru, Itagaki, Kei, Kajitani, Naoto, Abe, Hiromi, Okada‐Tsuchioka, Mami, Okamoto, Yasumasa, Takebayashi, Minoru
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons Australia, Ltd 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6852585/
https://www.ncbi.nlm.nih.gov/pubmed/31077478
http://dx.doi.org/10.1111/pcn.12859
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author Omori, Wataru
Itagaki, Kei
Kajitani, Naoto
Abe, Hiromi
Okada‐Tsuchioka, Mami
Okamoto, Yasumasa
Takebayashi, Minoru
author_facet Omori, Wataru
Itagaki, Kei
Kajitani, Naoto
Abe, Hiromi
Okada‐Tsuchioka, Mami
Okamoto, Yasumasa
Takebayashi, Minoru
author_sort Omori, Wataru
collection PubMed
description AIM: The efficacy of electroconvulsive therapy (ECT) has been established in psychiatric disorders but the high rate of relapse is a critical problem. The current study sought preventative factors associated with relapse after a response to ECT in a continuum of four major psychiatric disorders. METHODS: The records of 255 patients with four psychiatric disorders (83 unipolar depression, 60 bipolar depression, 91 schizophrenia, 21 schizoaffective disorder) were retrospectively reviewed. RESULTS: The relapse‐free rate of all patients at 1 year was 56.3% in the four psychiatric disorders without a difference. As a result of univariate analysis, three items could be considered as preventative factors associated with relapse: a small number of psychiatric symptom episodes before an acute course of ECT, the use of mood stabilizers, and the use of maintenance ECT. Multivariate analysis was performed, keeping age, sex, and diagnosis constant in addition to the three items, and small number of psychiatric symptom episodes before an acute course of ECT (P = 0.003), the use of lithium (P = 0.025), the use of valproate (P = 0.027), and the use of maintenance ECT (P = 0.001) were found to be significant preventative measures against relapse. CONCLUSION: The use of mood stabilizers, such as lithium and valproate, and maintenance ECT could be shared preventive factors associated with relapse after a response to ECT in four major psychiatric disorders.
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spelling pubmed-68525852019-11-21 Shared preventive factors associated with relapse after a response to electroconvulsive therapy in four major psychiatric disorders Omori, Wataru Itagaki, Kei Kajitani, Naoto Abe, Hiromi Okada‐Tsuchioka, Mami Okamoto, Yasumasa Takebayashi, Minoru Psychiatry Clin Neurosci Regular Articles AIM: The efficacy of electroconvulsive therapy (ECT) has been established in psychiatric disorders but the high rate of relapse is a critical problem. The current study sought preventative factors associated with relapse after a response to ECT in a continuum of four major psychiatric disorders. METHODS: The records of 255 patients with four psychiatric disorders (83 unipolar depression, 60 bipolar depression, 91 schizophrenia, 21 schizoaffective disorder) were retrospectively reviewed. RESULTS: The relapse‐free rate of all patients at 1 year was 56.3% in the four psychiatric disorders without a difference. As a result of univariate analysis, three items could be considered as preventative factors associated with relapse: a small number of psychiatric symptom episodes before an acute course of ECT, the use of mood stabilizers, and the use of maintenance ECT. Multivariate analysis was performed, keeping age, sex, and diagnosis constant in addition to the three items, and small number of psychiatric symptom episodes before an acute course of ECT (P = 0.003), the use of lithium (P = 0.025), the use of valproate (P = 0.027), and the use of maintenance ECT (P = 0.001) were found to be significant preventative measures against relapse. CONCLUSION: The use of mood stabilizers, such as lithium and valproate, and maintenance ECT could be shared preventive factors associated with relapse after a response to ECT in four major psychiatric disorders. John Wiley & Sons Australia, Ltd 2019-06-01 2019-08 /pmc/articles/PMC6852585/ /pubmed/31077478 http://dx.doi.org/10.1111/pcn.12859 Text en © 2019 The Authors. Psychiatry and Clinical Neurosciences published by John Wiley & Sons Australia, Ltd on behalf of Japanese Society of Psychiatry and Neurology This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Regular Articles
Omori, Wataru
Itagaki, Kei
Kajitani, Naoto
Abe, Hiromi
Okada‐Tsuchioka, Mami
Okamoto, Yasumasa
Takebayashi, Minoru
Shared preventive factors associated with relapse after a response to electroconvulsive therapy in four major psychiatric disorders
title Shared preventive factors associated with relapse after a response to electroconvulsive therapy in four major psychiatric disorders
title_full Shared preventive factors associated with relapse after a response to electroconvulsive therapy in four major psychiatric disorders
title_fullStr Shared preventive factors associated with relapse after a response to electroconvulsive therapy in four major psychiatric disorders
title_full_unstemmed Shared preventive factors associated with relapse after a response to electroconvulsive therapy in four major psychiatric disorders
title_short Shared preventive factors associated with relapse after a response to electroconvulsive therapy in four major psychiatric disorders
title_sort shared preventive factors associated with relapse after a response to electroconvulsive therapy in four major psychiatric disorders
topic Regular Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6852585/
https://www.ncbi.nlm.nih.gov/pubmed/31077478
http://dx.doi.org/10.1111/pcn.12859
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